Journal
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
Volume 32, Issue 3, Pages 712-U427Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/ATVBAHA.111.227389
Keywords
endothelium; microcirculation; nitric oxide; vascular biology; vasodilation
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Funding
- NIH [K23HL089326]
- Greater Milwaukee Foundation
- American Heart Association [10GRNT3880044]
- John A. Hartford Foundation
- Association of Specialty Physicians
- Clinical Translational Research Institute at the Medical College of Wisconsin
- National Institutes of Health [HL081587]
- Ruth L. Kirschstein National Institutes of Health [HL007792-15]
- Atlantic Philanthropies
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Objective-Hypoglycemia is associated with increased mortality. The reasons for this remain unclear, and the effects of low glucose exposure on vascular endothelial function remain largely unknown. We endeavored to determine the effects of low glucose on endothelial cells and intact human arterioles. Methods and Results-We exposed human umbilical vein endothelial cells to low glucose conditions in a clinically relevant range (40-70 mg/dL) and found rapid and marked reductions in nitric oxide (NO) bioavailability (P < 0.001). This was associated with concomitantly increased mitochondrial superoxide production (P < 0.001) and NO-dependent mitochondrial hyperpolarization (P < 0.001). Reduced NO bioavailability was rapid and attributable to reduced endothelial nitric oxide synthase activity and destruction of NO. Low glucose rapidly activated AMP kinase, but physiological activation failed to restore NO bioavailability. Pharmacological AMP kinase activation led to phosphorylation of endothelial nitric oxide synthase's Ser633 activation site, reversing the adverse effects of low glucose. This protective effect was prevented by L-N-G-Nitroarginine methyl ester. Intact human arterioles exposed to low glucose demonstrated marked endothelial dysfunction, which was prevented by either metformin or TEMPOL. Conclusion-Our data suggest that moderate low glucose exposure rapidly impairs NO bioavailability and endothelial function in the human endothelium and that pharmacological AMP kinase activation inhibit this effect in an NO-dependent manner. (Arterioscler Thromb Vasc Biol. 2012; 32:712-720.)
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